Duodenitis is an inflammatory disease of the duodenum, or rather, directly by the inflammation of its mucosa. Just note that the expression "stomach disease duodenitis" is absolutely wrong, since the inflammation of the stomach is called gastritis! That is, gastritis and duodenitis are similar in etiology and differ only in the localization of inflammation( stomach or duodenum).
What is this - duodenum? It is here that food is processed by juices - this is the process that prepares food for absorption. In addition, it produces some hormones, as well as metabolism in the body. In this regard, regardless of prevalence, duodenitis is a serious enough problem.
Classification of duodenitis
Duodenitis is classified according to different characteristics, so the etiology distinguishes between acute and chronic duodenitis;on the location of the inflammatory focus - a local and common form;on the defeat of the mucous membrane - superficial, interstitial, atrophic and erosive forms.
Individual duodenites are distinguished as a separate group, which arise against the background of other diseases( eg, fungal infection, tuberculosis, Crohn's disease, etc.).
In addition, for the morphological characteristics of duodenitis, the classification of 1990 is used, represented by R. Whithead, in which duodenites of the 1st degree( weak form), 2 degrees( moderate form) and 3 degrees( heavy form) are distinguished. And the first is distinguished by the absence of damage to the upper layer of the epithelium. At this stage, it is difficult to detect, but it is easy enough to treat unlike other stages.
Causes of duodenitis
The reasons why duodenitis develops are very heterogeneous. Most often it occurs, unfortunately, at an early age. This is due to the fact that the hormonal apparatus of the duodenum is still very weak due to its incorrect location. However, the risk of duodenitis is present in a person of absolutely any age. Also, one of the reasons for its development coincides with the cause of gastritis and peptic ulcer disease( Helicobacter pylori bacterium).
In addition, one of the main causes leading to the inflammation in the duodenum is chemical damage to the mucosa. As a rule, this happens if the contents of the stomach come from the stomach, which has an increased concentration of acid. Juice from the stomach, which has hyperacid properties, penetrates into the intestine, after which irritation of its mucous layer occurs, which leads to its acute inflammation.
Secondary duodenitis occurs as a consequence of delays in the duodenum, or the part of the intestine of food masses that is close to it. The cause of this process is duodenostasis, which is a reduced tone of the walls in the intestinal tube. The result of this phenomenon is that the contents of the stomach for a long period is at the top and adversely affects the mucosa.
Factors that affect the onset of acute inflammation of the duodenum( usually 1 degree) are excessive consumption of spicy foods, as well as alcoholic beverages, food poisoning or mechanical injury to the mucosa of the duodenum.
The chronic form of duodenitis develops in turn due to certain pathologies of the gastrointestinal tract. These include Zollinger-Ellison disease, intestinal ischemia( impaired circulation of blood), chronic impairment of fat absorption in the small intestine, Crohn's disease, stomach ulcer and many others.
A special role in the appearance of duodenitis, according to gastroenterologists, should be isolated bacterial infection, which causes the bacterium Helicobacter pylori. What it is? It is known that this microorganism is the main cause of gastritis, as well as peptic ulcer, both of the stomach and duodenum. For a long time, the aforementioned bacterium can exist completely without manifestations. It should be noted that in the case of a favorable atmosphere, this bacterium also begins to multiply, thus stimulating an increase in the release in the stomach of hydrochloric acid. When the acid is excessively acidic, the intestinal mucosa is broken. Thus, if untimely treatment or in case of its complete absence, soon a ulcer may appear on the site of duodenitis.
Also, chronic inflammation of the duodenal mucosa may appear on the basis of irregular nutrition and harmful food. In addition, the state of the nervous system, in particular severe stresses, has a major impact. Also, the use of certain drugs, foci of chronic diseases, and the presence of bad habits can contribute to the occurrence of duodenitis.
The main signs of duodenal duodenitis
In inflammation in the upper intestine, signs may not manifest themselves at all or be clearly pronounced regularly or periods. The main symptoms in which it is possible to suspect a diagnosis of 1 degree( initial stage) duodenal duodenal ulcer, are violations of digestion, poor appetite, discomfort in the abdominal cavity, especially after eating. There may also be constant dyspepsia, represented by flatulence, diarrhea and eructations. Periodic manifestations of nausea and vomiting, painful sensations in the central part of the abdominal cavity are possible. In some cases, there may also be the appearance of hungry, as well as aching pain, which can be given to the sternum.
In the presence of internal bleeding, symptoms such as bloody discharge in fecal or vomit masses, anemia and general apathy will also appear.
Different types of duodenitis have different clinical patterns of inflammation, so you can more accurately establish a diagnosis based on an anamnesis.
With duodenosis, the pain sensations are localized in the epigastric region, as well as the right hypochondrium. Pain can be seizure with a characteristic bursting character and twisting. In addition to pain, severe abdominal distension, as well as a rumbling and a feeling of "water transfusion" in the abdominal cavity. There may also be a bitter taste in the mouth when vomiting, which indicates the output of bile.
A frequent conclusion, which, unfortunately, is detected only on ultrasound is a deformation in duodenitis of the bulb of the DPC.This deformation is the result that preceded the ulcer. This defect on the mucous membrane is formed due to the acidic environment of the stomach. The initial department of the duodenum, which receives food directly from the stomach, has a small extension, why it is called the bulb of the DPC.It should be noted that if it is already deformed - this does not mean that the peptic ulcer has already developed! As a rule, the bulb of DPC is an indicator to conduct additional diagnostics to detect or deny possible diagnoses.
When duodenitis of the duodenum is combined with a ulcer, severe painful sensations occur on an empty stomach. As a rule, other signs of inflammation are also manifested, but this type of pain indicates the presence of a concomitant ulcer of the duodenum.
Inflammation also affects the lower intestine, that is, pain, as it were, "dropping" from the stomach into the small and large intestine. The patient thus manifests diarrhea, increased peristalsis, as well as bloating.
Diagnosis of duodenal duodenitis
Prolonged course of inflammation can lead to such a serious consequence, which is the atrophy of the mucous membrane in the duodenum. With this development of events, there is a disruption in the functioning of the digestive system by the enzyme, as well as a deterioration in the digestion of food, in connection with which nutrients in the intestine are less absorbed. Possible development of anemia, micronutrient deficiency, vitamin deficiency, as well as other problems with cardiovascular, muscular and nervous systems. That is why it is so important to diagnose the disease at the beginning of its development.
In order to diagnose duodenitis, you should consult a gastroenterologist. At what the expert can make the diagnosis, preliminary basing on the anamnesis and palpation of an abdominal cavity( painful sensations at a palpation of a zone of an epigastrium).In order to clarify the nature of the disease, as well as to differentiate it from other diseases, a number of comprehensive studies are conducted. It includes esophagogastroduodenoscopy, ultrasound, x-ray of the cavities of the stomach and duodenum, analysis of the composition and acidity of gastric juice, bacteriological analysis, coprogram, biochemical blood test. Unusual may seem to be a specific blood test for antibodies that are produced by the body to exclude or confirm the autoimmune etiology of duodenitis or gastritis.